Safe Surgical Anesthesia Is Demonstrated

Date October 16, 1846

Controversy has long surrounded the question of who deserves credit for developing surgical anesthetics, but it was clearly William Thomas Green Morton’s successful demonstration of ether in an operation that brought the attention of the medical professions to the possibilities of anesthetics.

Locale Georgia

Key Figures

• William Thomas Green Morton (1819-1868), Boston dentist who first demonstrated surgical anesthesia for the public
• Horace Wells (1815-1848), Boston dentist who attempted to use nitrous oxide as an anesthetic
• Charles Thomas Jackson (1805-1880), eccentric Boston physician and scientist who claimed full credit for Wells’s and Morton’s work
• Crawford Williamson Long (1815-1878), Georgia physician who first used ether in surgery

Summary of Event

On October 16, 1846, William Thomas Green Morton, a Boston dentist, gave the first public demonstration of the successful use of surgical anesthesia in the Massachusetts General Hospital, Although surgery had made considerable progress during the previous two centuries as anatomists had gradually delineated the major outlines of gross anatomy, surgery patients still faced excruciating pain and the near certainty of contracting secondary infections. Without the use of anesthetics, the agonies of the patients forced surgeons to operate as quickly as possible, and the shock and pain that the patients endured often proved disastrous. Dreaded diseases, such as hospital gangrene and blood poisoning, often hastened patients’ deaths. During the 1840’s, U.S. ingenuity had solved the problem of anesthesia; control of infection had to await the bacteriological revolution in the last half of the nineteenth century.

Among the many discoveries in the history of medicine, few have provoked so much controversy as that of anesthesia. No fewer than four American claimants to the honor of introducing this benevolent contribution to humanity vied for recognition during their lifetimes. The controversy also later acquired an international flavor. Simultaneous events in England further blurred the claim to discovery. The argument quickly focused on the comparative merits ether and chloroform. The debate has since been carried on by historians. The American contest, however, now rests largely between Crawford Williamson Long , who was the first to use surgical anesthesia, and William Thomas Green Morton, who was first publicly to demonstrate its use.

By 1840, the stage was set for the advent of anesthesia. Surgeons, who were as deeply troubled by the agonies of their patients as they were by the difficult logistics of operating on screaming, writhing patients, were eager for help. A growing humanitarian spirit, with its acute sensitivity to human suffering, made the public more receptive to innovations in this field. However, it was the rapid development of dentistry in the United States that created a strong demand for pain relievers. By that time, three anesthetic agents were available: nitrous oxide, sulfuric ether, and chloroform. The exhilarating effects of the first two gases were well known from recreational use of the gases; “ether frolics” and “laughing-gas” parties had become common indoor pastimes. In the course of such parties, it had been observed that individuals under the influence of the gases appeared to feel no pain.

The first professional person to see the possible significance of these chemical agents in relieving pain was Crawford W. Long, a Georgia physician. He had witnessed the effect of sulfuric ether during ether frolics and determined to try it as an aid to surgery. Between 1842 and 1846, Long performed eight operations using sulfuric ether on human patients. However, he made no effort to publish his work until after Morton’s demonstration of the anesthetic properties of ether in 1846.

Meanwhile, a Boston dentist, Horace Wells , was also experimenting with anesthesia. Wells had observed the results of nitrous oxide during laughing-gas parties and decided to see if it could provide the basis for painless extraction of teeth. After several successes, he arranged for a public demonstration of his technique at the Harvard Medical School. Precisely what happened there is unclear. Apparently the nitrous oxide had not reached its full effect on the patient. As Wells began to pull the patient’s tooth, the patient let out a terrified yell, and the students observing the demonstration began to laugh and hiss. Wells fled in embarrassment, leaving his instruments behind. After this humiliation, he arranged another demonstration, but this time he administered too large a dose of nitrous oxide and the patient nearly died. Wells retired in disgrace, giving up all attempts to use nitrous oxide as an anesthetic.

Meanwhile, William Morton, another Boston dentist, was investigating the problem of surgical anesthesia. At the suggestion of Charles Thomas Jackson , a well-known physician, geologist, and chemist, Morton experimented with ether. When he felt sufficiently confident about procedures, Morton persuaded the famous surgeonJohn Collins Warren to allow him to anesthetize one of his patients. It was Morton’s use of anesthesia during this operation on October 16, 1846, that introduced surgical anesthesia to the world. Jackson later demanded some credit for the discovery, but his claim was rejected by the public and the academic community.

Ironically, misery was the lot of the three medical professionals chiefly responsible for the introduction of anesthesia. Wells committed suicide soon after his unhappy appearance before the Harvard students. Morton sacrificed his career while fighting for recognition as the rightful discoverer of ether as an anesthetic and died a frustrated and bitter man. Jackson was ultimately committed to an insane asylum. Long escaped the litigation and public quarreling in which Jackson and Morton became embroiled, survived the Civil War (1861-1865), and died a respected and successful practitioner in Georgia. His failure to publish the results of his early experiments deprived him of credit for the discovery of anesthetic surgery, and had he not encountered the publicity given to Morton’s successful demonstration in 1846, Long might never have publicized his own work.

Significance

News of Morton’s demonstration of painless surgery spread rapidly throughout the world, and the use of anesthesia, a term suggested by Dr. Oliver Wendell Holmes , for surgical and obstetrical purposes quickly became general. In 1869, an acrimonious debate erupted between the English obstetrician Sir James Young Simpson and Henry Jacob Bigelow , a Boston physician. The controversy focused more on whether Simpson had taken more credit than he was due for the discovery of a safe anesthetic than on the superiority of ether over chloroform. As the number of surgical operations increased, so did the incidence of secondary hospital infections; it took another twenty years for the work of the Englishman Lord Joseph Lister in antiseptic , and later aseptic, techniques to alleviate this problem in American hospitals.

As a result of the use of anesthesia, surgery eventually became a healthier and relatively painless procedure for patients. The successful use of anesthesia also permitted the development of better surgical techniques and a more advanced understanding of anatomy. Nevertheless, as knowledge of anesthesia and bacteriology steadily widened, the way was being prepared for making the twentieth century the age of the surgeon.

Bibliography

Boland, Frank Kells. The First Anesthetic: The Story of Crawford Long. Athens: University of Georgia Press, 1950. Scholarly work that leaves little doubt that Long was the first person to use ether as an anesthetic.

Duncum, Barbara M. The Development of Inhalation Anaesthesia with Special Reference to the Years 1846-1900. London: Oxford University Press, 1947. The definitive work dealing with the background and controversy over surgical anesthesia, and its later development during the late nineteenth century. Includes a survey of political and social attitudes in various countries during the nineteenth century and illustrates how they influenced the study of anesthesia.

Fenster, Julie M. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. New York: HarperCollins, 2001. Engagingly written narrative of the bizarre careers of the three men most responsible for introducing modern anesthetics.

Keys, Thomas E. The History of Surgical Anesthesia. New York: Schuman’s, 1945. Traces the earliest attempts to relieve pain. Focuses on the broadening of the field of anesthesia during the late nineteenth and early twentieth centuries, including such topics as local, regional, and spinal anesthesia; rectal anesthesia; “twilight sleep”; and other anesthetic techniques.

Ludovici, L. J. Cone of Oblivion: A Vendetta in Science. London: Max Parrish, 1961. Centers on the anesthesia controversies that raged between 1840 and 1860.

MacQuitty, Betty. The Battle for Oblivion: The Discovery of Anesthesia. London: George S. Harrap, 1969. Follows Morton’s struggle for recognition; includes some beautiful photographs.

Shryock, Richard Harrison. Medicine and Society in America, 1660-1860. New York: New York University Press, 1960. This classic general history of U.S. medicine emphasizes the role of U.S. dentistry in the discovery of anesthesia.

Sykes, W. Stanley. Essays on the First Hundred Years of Anaesthesia. Edinburgh: E. & S. Livingstone, 1960. Includes a rich variety of illustrations and photographs. Establishes the political and social issues that were a part of the Victorian Age and serve as a background to the development of practical anesthetic procedures.

Wolfe, Richard J. Tarnished Idol: William Thomas Green Morton and the Introduction of Surgical Anesthesia: A Chronicle of the Ether Controversy. San Anselmo, Calif.: Norman, 2001. Meticulously researched biography of Morton. Wolfe acknowledges that Morton conducted the first successful public demonstration of anesthesia but credits him with contributing little else to the discovery and development of anesthesia.